Remote Insurance Authorization Specialist – Fast Pre-Auth

ensemblehp; United States; Remote; USD 35,000 - 39,000; Full time

Benefits offered by this job

Remote Work

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners is seeking a Bedded Insurance Authorization Specialist to secure initial and concurrent insurance authorizations for hospital admissions, ensuring medical necessity and timely submissions.

You will verify coverage, determine benefits, deductibles, coinsurance, and patient liabilities while minimizing denials and meeting regulatory requirements across the organization.

Qualifications

• Experience working with insurance companies and/or medical authorizations.
• Comprehensive understanding of insurance authorization requirements, contract benefits, CPT codes and medical terminology.
• Ability to use critical thinking and problem-solving to retain material quickly.
• Positive demeanor with strong verbal and written communication skills; professional in appearance and approach.
• Ability to handle stressful situations and manage multiple tasks simultaneously.
• Working knowledge of personal computers and common office equipment; access to online eligibility and pre-certification systems.
• Willingness to complete additional job-related training when offered.

Responsibilities

• Verify that patient health insurance is active and covers the procedure.
• Determine benefits, deductibles, coinsurance, and patient liabilities; notify patient when applicable.
• Verify coverage details and expected amounts prior to services.
• Ensure required authorizations are obtained and maintained in a timely manner; reduce denials.
• Review patient visit data to support medical necessity and payor criteria for authorization.
• Ensure services are within benefit plans and contracted providers are used.
• Aim for accuracy/quality and productivity above 95%.

Skills

Insurance experience

Medical authorizations

Critical thinking

Communication skills

Multi-tasking

Computer literacy

Training willingness

Tools

Online insurance eligibility systems

Pre-certification platforms

EHR systems

Job description

Ensemble Health Partners is seeking a Bedded Insurance Authorization Specialist to secure initial and concurrent insurance authorizations for hospital admissions, ensuring medical necessity and timely submissions.

You will verify coverage, determine benefits, deductibles, coinsurance, and patient liabilities while minimizing denials and meeting regulatory requirements across the organization.